CENTERS FOR DISEASE CONTROL October 23, 1981 / Vol. 30 / No. 41

Current Trends513 Rubella — United States, 1978-1981

Epidemiologic Notes and Reports 515 Raynaud's Phenomenon in a Found­

ry —Wisconsin Surveillance Summary

521 N u trition Surveillance — United States, 1980

MORBIDITY AND MORTALITY WEEKLY REPORT

Current Trends

Rubella — United States, 1978-1981

A record low number of 3,904 cases of rubella was reported in the United States for1 980. This was 66.9% less than the 1 979 total o f 1 1,795 cases, the previous record low. Be­tween 1 978 and 1 980, the number of reported rubella cases declined 78.6%. This trend con­tinued throughout the first 35 weeks of 1981 (ending September 5), when 1,717 cases of rubella were reported, a 46.3% decline from the 3,196 cases reported fo r the same period in 1980 (Figure 1).

Age-specific data were available fo r 2,964 (76.0%) of the cases reported fo r 1980. The reported age-specific incidence rate o f rubella has decreased for all age groups over the past2 years, w ith the greatest decline being that fo r the 1 5- to 24-year-old group (Table 1). This has resulted in a marked change in the age-specific characteristics. In 1 978, the highest age- specific incidence rate was fo r 1 5- to 1 9-year olds. From 1 978 through 1 979, 73.8% of the reported cases o f rubella were among persons 3=1 5 years old. For 1 980, only 46.6% of the cases were reported among persons 3=15 years old, and the highest incidence rate was for the < 5-year olds.Reported by Surveillance and Assessment Br, Immunization Div, Center fo r Prevention Services, CDC. Editorial Note: Initially, rubella-control programs in the United States emphasized vaccina­tion of preschool and elementary school children; vaccination of older individuals received only secondary emphasis. This strategy caused a dramatic decline in reported rubella and eliminated the characteristic 6- to 9-year cycle of epidemic rubella ( / ) . There was also a rnarked change in the age characteristics fo r reported rubella cases. Whereas rubella was con­sidered a disease of young children before vaccine licensure in 1969, from 1976 through 1979 approximately 70% of reported rubella cases were among individuals > 1 5 years of age and the highest incidence rate was fo r the 1 5- to 1 9-year olds (2).

FIGURE 1. Rubella cases, by week of report. United States, 1978-1981*

U.S. DEPARTMENT OF HEA LTH A N D HUM AN SERVICES / PUBLIC HEALTH SERVICE

514 MMWR October 23 ,1981

Rubella — ContinuedThe 1 980 and 1 981 surveillance data show a continuation of the rapid decline in reported

rubella to record low levels. Much of this recent decrease is probably due to the Childhood Im­munization Initiative which began in 1 977. The goal o f the initiative was to achieve and main­tain immunization levels in excess of 90% for all childhood, vaccine-preventable diseases, including rubella. Because of improvement in and better enforcement of school immunization laws, rubella vaccination is now required in many states. The Measles Elimination Initiative, begun in 1978, has probably further influenced reduction in the incidence o f rubella since most o f the measles vaccine administered during this program has been given as MMR (mea­sles, mumps, rubella vaccine) or MR (measles, rubella vaccine).

Data on age-specific incidence rates fo r 1 980 show that rates for adolescents and young adults are now similar to those fo r young children. This shift probably results from the fact that the young children who were targeted for vaccination in 1969 moved into older age groups and from the increased effort over the past 2-3 years to vaccinate adolescents and young adults. Increased efforts to vaccinate adolescents and young adults were prompted by continued reporting of 27-50 cases of congenital rubella syndrome per year from 1971 through 1979 ( 1 ) and by the knowledge that 10%-25% o f adolescents and adults were sus­ceptible to rubella (3-5).

The current strategy for rubella control is based on continued routine vaccination of all children > 1 2 months of age, vaccination o f all school children not vaccinated in infancy and vaccination of susceptible adults —particularly females and/or hospital personnel (6). Such a combined strategy, if applied rigorously, may eliminate both rubella and the congenital rubella syndrome in the United States.References1. CDC. Rubella surveillance, January 1976-December 1 978. Atlanta: CDC, May 1 980.2. CDC. R ubella -U nited States 1977-1980. MMWR 1980;29 :378-80 .3. S ch iff GM, Linnemann CC Jr, Shea L, et al. Rubella surveillance and immunization among college

women. Obstet Gynecol 1 9 7 4 ;4 3 :142-7.

TABLE 1. Percentage distribution and incidence rates* of reported rubella cases, by age. United States, 1978-1980

Age(years)

1978 1979 1980 Percentage rate change 1978-1980Number % Rate Number % Rate Number % Rate

< 5 786 7.6 9.0 799 10.0 7.5 715 24.1 5.8 -3 5 .65-9 619 6.0 6.5 583 7.3 5.2 477 16.1 3.8 -4 1 .5

10-14 1,051 10.2 10.0 943 11.8 7.7 390 13.1 2.8 -7 2 .015-19 4,543 44.1 38.3 2,748 34.6 19.6 602 20.3 3.7 -9 0 .320-24 2,540 24.7 22.3 1,8031 22.6 13.0 4381 14.8 2.7 -8 7 .925-29 363 3.5 3.6 5 1 6 t 6.5 4.2 1 65 t 5.6 1.1 -6 9 .4> 3 0 394 3.8 0.6 569 7.2 0.8 177 6.0 0.2 -6 6 .7

Total ageknown 10,296 56.4 - 7,961 67.7 - 2,964 76.0 - -

Tota l ageunknow n 7,973 43.6 — 3,834 82.3 — 940 24.0 — -

Total 18,269 100.0 8.4 11,795 100.0 5.4 3,904 100.0 1.7 -7 9 .8

•Incidence rate equals cases/100,000 population extrapolated from the age d is tribu tion o f cases reported by age from 44 reporting areas in 1978, 46 areas in 1979 and 51 areas in 1980. tExcludes Arizona.

Vol. 30/No. 41 MMWR 515

Rubella — Continued4. Pollard RB, Edwards EA. Epidemiologic survey of rubella in a military recruit population. Am J Epide­

miol 1975 ;101 :431-7 .5- Preblud SR, Halsey NA, Herrmann KL, et al. Susceptibility to measles and rubella in merchant marine

cadets, Kingsport, Long Island, New York, 1977. Presented at the Immunization Conference, W ash­ington, DC, March 1978.

6. Immunization Practices Advisory Committee. Rubella prevention. MMWR 1981 ;30 :37 -42 ,47 .

Epidemiologic Notes and Reports

Raynaud's Phenomenon in a Foundry — Wisconsin

A high prevalence of Raynaud's phenomenon (also called vibration-induced white finger, or VWF) among metal foundry workers exposed to hand vibration when using air hammers and grinding tools was recently found in a National Institute fo r Occupational Safety and Health (NIOSH) investigation.

In June 1 980, the International Molders and Allied Workers Union requested that NIOSH evaluate 74 men employed as chippers and grinders in 2 metal casting cleaning rooms (51 in Room A and 23 in Room B) at a foundry in Wisconsin. In August and September 1 980, NIOSH investigators conducted medical evaluations and assessed vibration exposure.

Sixty-four employees (47 in Room A and 1 7 in Room B) were interviewed and examined. Fifty-five percent (26/47) of Room A employees and 18% (3/17) o f Room B employees reported experiencing symptoms of Raynaud's phenomenon since beginning work as chip- Pers. Men who were symptomatic also tended to have decreased sensory abilities in their hands. Of 14 men w ith 3 or more years of work as chippers in Room A, 2 had not suffered episodes of Raynaud's phenomenon.

Assessment of vibration exposure revealed that the chipping ham m er (a tool similar to a small jackhammer used to remove excess metal from castings) had handle accelerations in the range of 1 5 -60 x g (comparable to those of similar tools previously measured by NIOSH [ 71), and the handles of the grinding machines had accelerations in the range of 1 5 -20 x g (15-50 times the level of similar tools previously measured by NIOSH). Room A employees used the chipping hammer approximately 2-3 hours/day and the grinding machines 4-5 hours/day, while Room B employees used vibrating tools to a lesser extent because the Room B castings required less thorough or precise metal removal. The lower prevalance of Ray­naud's symptoms in Room B employees may be due to the lower mean years of exposure of these workers (Room B, 2.3 years; Room A, 4.1 years) and the lesser time per day that they used vibrating tools.S p o rted by W Taylor, MD, University o f Dundee, Scotland; Physical Agents Effects Br, D iv o f Biomedical and Behavioral Science, Hazard Evaluations and Technical Assistance Br, D iv o f Surveillance, Hazaro Valuation, and Field Studies, NIOSH, CDC.Editorial Note: European and American studies of foundry workers using chippers and of loggers operating chain saws have shown prevalences of Raynaud's phenomenon ranging from 20% to 90% (depending on the duration and intensity o f vibration exposure), while <10% of male controls not exposed to vibration experienced symptoms of Raynaud's phe­nomenon. The increased risk o f developing Raynaud's phenomenon due to long-term use of vibrating hand tools has received little attention in the United States (2-5).

The initial symptoms of vibration-induced Raynaud's phenomenon consist of an episodic blanching and numbness of a fingertip and are usually initiated by exposure to cold. W ith con­tinued vibration exposure, VWF may involve more fingers, require less cold stimulus fo r initia-

516 MMWR October 23, 1981

Raynaud's Phenomenon — Continuedtion and, consequently, occur more frequently. Even persons w ith only moderately advanced VWF avoid outdoor activities (occupational endeavors, fishing, hunting, etc.) in cool or cold weather, because exposure to cold brings on attacks of Raynaud's phenomenon, and they are unable to grasp objects or safely hold tools. Many persons with advanced disease have de­creased sensory abilities in the hand and are unable to grasp small objects or perform fine motor and/or hand movements. A small proportion of workers develop ulceration or gangrene of the fingers because of peripheral arterial occlusion. If vibration exposure is stopped before symptoms become severe, episodes of Raynaud's phenomenon usually subside over a period of several years. The pathogenesis o f the initial blanching episodes and subsequent sensory and motor impairment is not well understood, particularly whether the primary lesion is neuro­logic or vascular (2,4,5).

While changes in work practice may lessen an individual worker's vibration exposure, ulti­mate control o f vibration-induced Raynaud's phenomenon depends on development of tools which greatly reduce the vibration imparted to the user's hand.References1. Wasserman D, Taylor W , Behrens V, et al. Vibration white finger disease in U.S. workers using

pneumatic chipping and grinding hand tools. Cincinnati: National Institute fo r Occupational Safety and Health (in press).

2. Taylor W, Pelmear PC. Vibration white finger in industry. London: Academic Press, 1 975.(Continued on page 521)

TABLE I. Summary — cases of specified notifiable diseases. United States[Cumulative totals include revised and delayed reports through previous weeks.]

41st WEEKENDINGMEDIAN

1976-1980

CUMULATIVE, FIRST 41 WEEKSDISEASE October 17

1981October 11

1980October 17

1981October 11

1980MEDIAN

1976-1980

Aseptic meningitis 311 243 1 82 7 ,0 9 5 5 ,7 3 5 4 ,8 8 3Brucellosis 6 1 3 1 24 145 1 *5Chicken pox 855 6 1 0 6 2 0 1 6 9 ,7 3 5 1 5 9 ,8 8 0 1 5 9 ,8 8 0Diphtheria - - - 3 2 63Encephalitis: Primary (arthropod-borne & unspec.) 45 66 39 1 ,0 7 8 9 1 4 91+

Post-infectious 5 6 6 69 171 183Hepatitis, V ira l: Type B 3 5 3 3 98 2 87 1 5 ,8 9 7 1 4 ,0 30 1 1 ,8 0 7

Type A 4 14 6 3 8 6 12 1 9 ,4 4 6 2 2 ,1 1 0 2 3 , * 5 3Type unspecified 1 97 2 32 1 7 7 8 ,5 4 9 9 ,0 0 2 6 ,9 3 8

Malaria 21 33 11 1 ,0 9 2 1 ,6 1 1 588Measles (rubeola) 24 64 87 2 ,7 2 2 1 3 ,0 2 1 2 * . 3 75Meningococcal infections: Total 4 7 49 40 2 ,7 8 8 2 , 160 1 .9 * 0

Civilian 47 49 40 2 ,7 7 7 2 , 1 44 1 ,9 1 7M ilitary - - . 11 16 17

Mumps 4 0 92 1 30 3 ,3 7 3 7 ,3 9 2 1 3 .8 8 9Pertussis 26 43 4 3 9 5 4 1 ,3 5 6 1 .3 5 *Rubella (German measles) 6 34 48 1 .8 1 5 3 , 388 1 0 . 890Tetanus - - 1 4 5 6 7 58Tuberculosis 4 86 577 4 59 2 1 ,2 0 8 2 1 ,3 3 3 2 2 .9 1 1Tularemia 3 8 4 209 181 1 3 *Typhoid fever 26 27 12 4 55 409 * 0 1Typhus fever, tick-borne (Rky. Mt. spotted) 16 26 16 1 ,1 1 8 1 ,0 8 5 9 75Venereal diseases:

Gonorrhea: Civilian 2 0 ,0 8 4 2 3 ,7 5 7 1 9 ,8 4 5 7 8 4 ,8 8 7 7 8 9 ,2 6 7 7 8 9 . 267M ilitary 4 0 0 974 3 93 2 2 ,0 2 6 2 1 ,9 2 5 2 1 .7 9 6

Syphilis, primary & secondary: Civilian 6 18 537 4 9 7 2 3 ,8 4 8 2 0 ,9 1 4 1 9 .0 2 2M ilitary 21 3 3 306 251 2 * *

Rabies in animals 104 108 70 5 ,7 8 9 5 ,2 3 2 2 .5 1 2

TABLE II. Notifiable diseases of low frequency. United States

Anthrax

CUM. 1981

Poliomyelitis: Total

CUM. 1981 ̂

4Botulism 61 Paralytic 3Cholera 3 Psittacosis (Ariz. 1, Calif. 2) 88Congenital rubella syndrome (Calif. 1) 10 Rabies in man 1Leprosy(Calif. 2) 198 Trichinosis 1 15Leptospirosis (Mich. 1) 37 Typhus fever, flea-borne (endemic, murine) 37Plague 9

A ll delayed reports and corrections w ill be included in the follow ing week's cumulative totals.

Vol. 30/NO.41 MMWR 517

TABLE III. Cases o f specified notifiable diseases, United States, weeks ending

October 17, 1981 and October 11, 1980 (41st week)

ASEPTIC BRU­ r u ir i f cmENCEPHALITIS HEPATITIS (VIRAL), BY TYPE

REPORTING AREAMENIN­GITIS

CEL­LOSIS

LmUIVt IM-POX DIPHTHERIA

Primary Post-in-fectious B A Unspecified

MALAHIA

1981 1981 1981 1981 CUM.1981 1981 1980 1981 1981 1981 1981 1981

CUM.1981

UNITED STATES 311 6 855 - 3 45 66 5 353 414 197 21 ,09 2

NEW ENGLAND 9 _ 108 _ - - 1 - 23 19 15 2 59Maine - - 46 - - - - - 2 1 1 - 1N.H. 1 . 4 - - - - - - - - - 3Vt. - - 5 - - - - - 1 3 - - 6Mass. 2 - 35 - - - 1 - 5 3 14 - 31R.I. 3 - 5 - - - - - 2 3 - - 3Conn. 3 13 - - - “ 13 9 2 15

MID. ATLANTIC 27 . 35 - _ 2 3 _ 53 30 13 6 146Upstate N.Y. 8 - 11 - - 1 2 - 6 6 2 - 34N.Y. City 2 - 24 - - - - 26 11 4 5 55N.J. 6 NN - - - - 21 13 7 - 42Pa. 11 - - - - I 1 NA NA NA 1 15

E.N. CENTRAL 134 _ 356 . _ 27 24 5 51 57 12 - 52Ohio 69 - 40 - - 13 10 5 13 12 4 - 8Ind. 19 - 10 - - 8 - 7 8 1 - 6III. - 18 - - - - 6 9 4 - 17Mich. 46 - 183 - - 4 4 - 24 26 3 - 21Wis. 105 - - 1 2 1 2 - “

W.N. CENTRAL 14 2 83 _ _ 3 5 _ 20 23 8 1 31Minn. 6 1 1 - - 3 - - 5 3 1 1 12Iowa 2 1 43 - - - 3 - 2 9 - - 4Mo. 1 - 1 - - - 1 - 5 7 3 - 3N. Dak. 1 - 4 — - - - - - - - - 1S. Dak. - - - - - - - - « - - - INebr. 3 _ 13 - - - 1 - 5 2 3 - 2Kans. 1 21 - - - - - 3 2 1 “ 8

S. ATLANTIC 52 2 116 _ 1 4 6 _ 91 57 32 4 133Del. - 1 - - - - - - 2 1 - - 1Md. 8 _ 15 - - 1 - - 32 5 5 3 31D.C. - - - - - - - - 5 2 1 - 9Va. 19 - 4 - - 1 1 - 11 1 2 - 27W. Va. 4 1 55 - - 1 - - 2 6 - - 4N.C. 3 - NN — - I 2 - 4 5 4 - 11S.C. 2 - - - - - 1 - 3 2 6 - 2Ga. 2 - 2 - - - - - 7 6 - - 8Fla. 14 - 40 - 1 - 2 25 29 14 1 40

E.S. CENTRAL 16 1 23 _ _ 1 2 _ 19 16 2 . 10Ky. 1 - 22 - - - - - 3 6 1 - -Tenn. 6 - NN - - 1 - - 2 4 1 - -Ala. 8 - - - - - - - 12 2 - - 9Miss. 1 1 1 - - - 2 - 2 4 - - 1

W.S. CENTRAL 13 I 20 _ _ 2 20 _ 33 93 59 3 87Ark. - - - - - - - 1 3 3 - 4La. 1 - NN - - - - - 4 18 16 - 7Okla. 2 - - - - 1 - - 8 9 4 - 6Tex. 10 1 20 - “ 1 20 “ 20 63 36 3 70

MOUNTAIN 17 _ 9 _ 1 1 3 . 14 33 19 2 38Mont. 1 - - - I - - - - 1 - - 1Idaho 5 - - - - - - - - 4 - - 3Wyo. - - 1 - - - - - - 1 - - -Colo. 2 - 2 - - - - - 5 9 3 - 18N. Mex. 1 - - - - - - - - 2 3 1 3Ariz. 6 - NN - - 1 3 - 6 10 12 1 6Utah 2 - - - - - - - - - - - 4Nev. 6 - - - - 3 6 1 - 3

PACIFIC 29 _ 105 _ 1 5 2 _ 49 86 37 3 536Wash. 4 - 89 - - 2 - - 3 11 1 1 25Oreg. 1 - - - - - - - 12 19 8 - 15Calif. 24 - 4 - - 3 - - 31 54 28 1 486Alaska _ _ _ _ 1 - 2 - - - - - 1Hawaii - “ 12 “ - “ “ 3 2 “ 1 9

Guam NA NA NA NA _ NA _ _ NA NA NA NA 2P.R. - - 19 - - - - - 8 21 14 - 11V.l. - — — — — — — — - - — — 4Pac. Trust Terr. NA NA NA NA - NA - " NA NA NA NA -NN: Not notifiable. NA: Not available.A ll delayed reports and corrections w ill be included in the following week's cumulative totals.

518 MMWR October 23, 1981

TABLE II I (Cont.'d). Cases of specified notifiable diseases. United States, weeks endingOctober 17,1981 and October 11,1980 (4lst week)

REPORTING AREAMEASLES (RUBEOLA) MENINGOCOCCAL INFECTIONS

TOTALMUMPS PERTUSSIS RUBELLA TETANUS

1981 CUM.1981

CUM.1980 1981 CUM.

1981CUM.1980 1981 CUM.

1981 1981 1981 CUM.1981

CUM.1981

UNITED STATES 24 2« 722 1 3 ,0 2 1 47 2 ,7 8 8 2 ,1 6 0 40 3 .3 7 3 26 6 1 ,3 1 5 45

NEW ENGLAND 4 86 674 3 182 116 I 172 1 2 118 2Maine - 5 33 I 22 5 1 33 - - 33 -N.H. - 7 331 - 17 7 - 21 1 2 48 -V t 3 226 - 7 14 - 6 - - - -Mass. 4 61 58 2 60 39 - 47 _ - 25 _R.I. - - 2 - 16 9 - 22 - - . - -Conn. “ : 10 24 - 60 42 - 43 - - 12 2

MID. ATLANTIC - 824 3 ,8 0 3 12 392 374 3 576 7 _ 217 3Upstate N.Y. 215 695 I 129 115 118 1 - 105 1N.Y. City - 87 1 ,1 9 0 2 6 * 95 1 80 6 - 54 2N.J. - S8 837 3 89 81 89 - - 47 -Pa. - • 4 4 4 1 .0 8 1 6 113 83 289 - - 11 -

E-Hi. CENTRAL « • 1 2 .4 3 0 5 338 276 18 943 4 1 373 7Ohio » : u 389 3 130 79 I 155 1 - 3 1Ind. - 9 92 — 45 41 1 111 1 - 132 2III. - 23 342 - 79 81 180 I - 89 -Mich. 30 241 2 79 60 12 316 1 - 34 3Wis. ■ 3 1 ,3 7 5 - 5 15 4 181 - 1 115 1

W.N. CENTRAL 9 1 .3 3 4 2 125 79 4 191 1 _ 77 3Minn. - 2 1 .0 9 9 2 44 18 8 1 - 6 2Iowa — 1 2 0 — 21 9 1 54 - - 4 -Mo. - ; 1 65 — 38 37 18 - . 2 1N. Dak. - - — — 2 I _ _ _ _S. Dak. - - _ _ 5 5 1 _ _ _ _Nebr. 4 83 — - - 3 - . I _Kans. - 1 67 - 15 9 3 107 - - 64 -

S ATLANTIC 12 4 40 1 ,9 4 7 12 643 517 4 486 2 2 141 8Del. - - 3 - 4 2 - 10 - - 1 -Md. - 5 83 1 44 46 - 86 - - 1 -D.C. 1 - - 3 2 - 3 - - - -Va. - 9 327 1 80 50 - 122 1 1 12 _W. Va. - 9 9 1 24 18 - 82 - - 22 -N.C. - 3 130 2 95 9 2 - 18 - ' - 5 2S.C. - 2 159 3 82 58 - 15 - - 8 2Ga. - 112 826 I 107 92 - 38 - 1 37 IFla. 12 299 410 3 2 04 157 4 112 1 - 55 3

E.S CENTRAL _ 4 331 3 199 185 1 81 _ _ 37 2Ky. - - 55 - 56 58 - 40 - . 21 _Tenn. - 2 170 - 56 50 - 21 - - 15 -Ala. - 2 22 2 62 50 - 16 - - I 2Miss. “ - 84 I 25 27 1 4 - - - "

W.S. CENTRAL 6 875 950 6 444 236 3 206 _ _ 165 11Ark. 3 21 16 - 26 18 - 5 - 3 3La. 4 11 3 109 88 - 5 - - 9 2Okla. - 6 775 - 37 18 - - - _ 1 1Tex. 3 844 148 3 272 112 3 196 - - 152 5

MOUNTAIN _ 35 473 2 115 84 _ 121 1 1 90 2Mont. - - 2 - 9 3 - 10 - - 4 -Idaho - 1 - - 4 4 - 6 _ _ 3 _Wyo. - 1 - - 1 3 - 1 1 1 11 -Colo. - 10 24 2 42 21 - 45 - - 27 -N. Mex. 8 12 - 7 10 - - - - 5 -Ariz. - 5 379 - 20 14 - 29 - _ 20 1Utah - - V7 - 5 6 - 17 - . 8 1Nev. 10 9 27 23 “ 13 - " 12 -

PACIFIC 2 368 1 .0 7 9 2 353 29 3 6 597 10 _ 597 7Wash. - 3 177 - 62 51 2 145 3 - 89 -Oreg. - 5 - - 51 47 - 62 - - 51 -Calif. 2 353 890 1 222 186 3 357 7 _ 445 7Alaska - 6 1 11 9 - 11 _ _ 1Hawaii “ 7 6 4 - 1 22 - - 11 -

Guam NA 5 6 _ _ 1 NA 6 NA NA 1P.R. 3 283 156 1 11 9 4 139 1 - 4 5V .l. - 25 6 - 1 1 - 5 . . I _Pac. Trust Terr. NA I 11 - - - NA 15 NA NA 1 -NA: Not available.A ll delayed reports and corrections w ill be included in the following week's cumulative totals.

Vol. 30/No. 41 MMWR 519

TABLE III (Cont.'d). Cases of specified notifiable diseases. United States, weeks ending October 17, 1981 and October 11,1980 (4lst week)

REPORTING areaTUBERCULOSIS TULA­

REMIATYPHOIDFEVER

TYPHUS FEVER (Tick-borne)

(RMSF)

VENEREAL DISEASES (Civilian) RABIES(m

Animals)GONORRHEA SYPHILIS (Pri. & Sec.)

1981 CUM.1981

CUM.1981 1981 CUM.

1981 1981 CUM.1981 1981 CUM.

1981CUM.1980 1981 CUM.

1981CUM.1980

CUM.1981

u n it e d s t a t e s 4 86 2 1 ,2 0 8 209 26 455 16 1 ,1 1 8 20 0 84 7 8 4 ,8 8 7 7 8 9 ,2 6 7 618 2 3 ,8 4 8 2 0 ,9 1 4 5 ,7 8 9

n ew ENGLAND 14 611 3 _ 16 _ 9 404 1 9 ,7 1 9 2 0 ,0 1 6 9 4 68 412 39Maine 3 41 - - 1 - - 22 1 ,0 2 1 I , 156 - 5 5 13N.H. - 18 - - - - - 9 698 711 - 11 3 7V t - 20 1 - - - — 9 336 459 1 15 5 -Mass. 7 345 I - 8 - 5 128 8 ,2 0 1 8 ,4 4 1 - 297 242 11R.I. L 46 - - - - 2 45 1 ,1 5 4 1 ,2 8 2 - 26 26 2Conn. 3 141 1 - 7 “ 2 191 8 ,3 0 9 7 ,9 6 7 8 1 14 131 6

MID. ATLANTIC 51 3 ,2 9 1 10 3 69 1 40 2 »682 9 4 ,9 7 6 8 6 ,9 6 0 83 3 ,4 8 3 2 ,9 2 8 96Upstate N.Y. 14 595 10 - 12 - 14 615 1 6 ,2 8 1 1 5 ,8 8 5 3 308 256 67N.Y. City 20 1 ,2 4 4 - 2 38 - 3 1 ,3 4 8 3 9 ,6 4 0 33, 467 53 2 ,0 9 7 1 ,8 9 4 -N.J. 8 718 - - 11 1 10 160 1 7 ,8 9 6 1 6 ,1 2 8 17 502 356 21Pa. 9 734 - 1 8 13 559 2 1 ,1 5 9 2 1 ,4 8 0 10 576 422 8

J-N. c e n t r a l 6 6 2 ,8 8 5 5 2 35 _ 46 2 ,4 8 6 1 1 4 ,8 0 3 1 2 1 ,8 7 6 13 1 ,6 6 5 1 ,9 8 1 770Ohio 1 4 535 - - 9 - 35 1 ,1 5 6 3 7 ,3 6 3 3 2 ,4 3 0 4 233 299 60Ind. 9 332 4 - 2 - 3 253 1 0 ,2 1 5 1 2 ,0 9 8 3 237 150 82III. 30 1 ,1 7 4 - 2 15 - 6 248 3 0 ,3 9 8 3 8 ,2 6 8 - 822 1 ,1 3 1 490Mich. 11 691 1 - 7 - I 580 2 5 ,9 5 1 2 7 ,7 8 4 4 297 326 13Wis. 2 153 “ - 2 - - 249 1 0 ,8 7 6 1 1 ,2 9 6 2 76 75 125

W-N. CENTRAL 8 732 31 . 18 1 50 I ,2 8 2 3 7 ,7 8 8 3 7, 265 19 5 23 277 2 ,3 2 2Minn. 2 127 - - 2 - 2 167 5 ,7 2 3 6 , 164 4 164 96 402Iowa - 71 - - 3 - 7 85 4 ,0 7 1 4 ,0 3 4 - 21 22 760Mo. 5 337 25 - 8 - 26 686 1 7 ,7 8 4 1 6 ,3 3 4 11 291 129 210N. Dak. - 28 - - - - - 15 476 532 1 8 3 330S. Dak. - 53 1 - 1 - - 28 1 ,0 3 5 1 ,1 1 9 - 2 4 276Nebr. - 20 3 - 2 - 3 64 2 ,7 9 7 2 ,8 8 1 2 9 7 168Kans. 1 96 2 - 2 1 12 237 5 ,9 0 2 6 , 201 1 28 16 176

£ ATLANTIC 91 4 ,6 0 4 15 1 58 10 643 5 ,0 8 8 1 9 5 ,1 6 5 1 9 7 ,8 1 9 221 6 ,4 3 1 5 ,0 5 2 490Del. 1 55 1 - - - 3 59 3 ,1 1 0 2 ,8 0 4 - 13 14 IMd. 10 474 - - 14 1 58 622 2 2 ,9 8 6 2 1 ,1 9 6 14 470 351 40D.C. 6 279 - - 1 I I 214 1 1 ,0 4 1 1 3 ,7 4 4 12 526 374 -Va. - 468 3 - 1 3 137 332 1 7 ,8 3 9 18, 001 29 558 448 100W. Va. 3 146 - - 6 - 6 65 2 ,9 6 6 2 ,6 6 0 1 18 15 25N.C. 1 8 807 4 1 3 5 285 1 ,1 7 5 3 0 ,1 8 1 2 8 ,9 0 7 17 5 09 363 16S.C. 8 42 7 3 - 1 - 101 412 1 8 ,9 1 5 1 8 ,6 3 1 16 4 4 4 293 37Ga. 12 757 4 - 4 - 72 9 39 4 0 ,4 7 7 3 8 ,5 9 7 48 1 ,5 9 6 1 ,4 6 5 189Fla. 33 1 ,1 9 1 - - 28 “ 10 1 ,2 7 0 4 7 ,6 5 0 5 3 ,2 7 9 84 2 ,2 9 7 1 ,7 2 9 82

E S. CENTRAL 74 1 ,9 0 5 8 _ 7 2 129 1 ,5 7 9 6 5 ,9 3 6 6 4 ,2 5 9 27 1 ,5 7 1 1 ,7 4 9 393Ky. 17 468 3 - - - 2 276 8 , 155 9 ,4 1 6 2 78 111 114Tenn. 17 6 39 5 - 3 1 80 497 2 4 ,9 3 2 2 3 , 186 8 573 733 187Ala. 36 524 - - 2 - 20 522 2 0 ,1 2 0 1 9 ,0 5 7 9 461 385 88Miss. 4 274 - - 2 1 27 284 1 2 ,7 2 9 1 2 ,6 0 0 8 4 59 520 4

W-S. CENTRAL 73 2 ,4 1 6 94 12 113 1 166 2 ,7 4 4 1 0 4 ,6 9 7 9 9 ,5 5 4 129 5 ,7 9 2 4 ,2 0 0 953Ark. 7 267 51 - 4 - 38 456 8 ,2 2 1 7 ,8 8 2 2 126 162 133La. 10 441 5 - 2 - - 406 1 8 ,2 2 8 1 8 ,1 3 8 29 1 ,3 2 2 1 ,0 5 5 33Okla. - 263 24 - 4 - 94 335 1 1 ,2 9 4 1 0 ,0 0 1 8 130 82 187Tex. 56 1 ,4 4 5 14 12 103 1 34 1 ,5 4 7 6 6 ,9 5 4 6 3 , 533 90 4 ,2 1 4 2 ,9 0 1 600

m o u n t a in 11 593 35 _ 22 _ 28 820 3 0 ,9 7 9 3 0, 574 14 596 492 235Mont. 28 5 - 4 - 12 38 1, 144 1, 158 - 11 2 110Idaho - 8 k. - - - 5 32 1 , 388 1 ,3 0 5 - 17 16 7Wyo. - 9 1 - - - 5 8 770 896 1 10 10 17Colo. 1 71 8 - 8 - 1 260 8 , 162 8 ,3 0 5 6 178 129 35N. Mex. 3 116 3 - - - - 87 3 ,4 1 5 3 , 718 2 105 82 27Ariz. 7 273 - - 9 - - 224 9 , 293 8 , 288 4 150 176 25Utah - 47 13 - 1 - 2 36 1 ,5 4 9 I t 534 1 23 13 9Nev. - 41 I - - - 3 135 5 ,2 5 8 5 ,3 7 0 - 102 64 5

PACIFIC 98 4 ,1 7 1 8 8 117 1 7 2 ,9 9 9 1 2 0 ,8 2 4 1 3 0 ,9 4 4 103 3 ,3 1 9 3 ,8 2 3 491Wash. 8 304 1 - 3 - 1 341 1 0 ,2 0 5 1 1 ,1 5 7 - 112 199 15°reg. 4 153 1 - 4 - 278 7 ,4 6 5 8 , 882 3 86 89 9Calif. 78 3 ,5 3 3 6 5 106 1 6 2 ,2 2 8 9 7 ,4 7 6 1 0 5 ,2 1 2 99 3 ,0 5 3 3 ,3 9 5 451Alaska - 48 - - - - 91 3 ,2 0 9 3 , 137 - 12 8 16Hawaii 8 133 3 4 “ “ 61 2 ,4 6 9 2 , 556 1 56 132

Guam MA 28 _ NA _ NA NA 72 105 NA _ 5 _P.R. 1 339 - - 4 - - 30 2 ,5 5 6 2 ,1 5 5 5 529 4 89 63V.l. - I - - 6 - 6 181 108 - 16 10 -J*ac. Trust Terr. 'i A 49 - NA - NA NA 329 327 NA - - -NA: Not available.All delayed reports and corrections w ill be included in the following week's cumulative totals.

520 MMWR October 23, 19®̂

TABLE IV. Deaths in 121 U.S. cities,* week endingOctober 17, 1981 (4lstweek)

REPORTING AREA

ALL CAUSES, BY AGE (YEARS)P&l»’TOTAL

REPORTING AREA

ALL CAUSES. BY AGE (YEARS)

ALLAGES > 6 5 45-64 25-44 1 24 < 1

ALLAGES > 6 5 45 64 2544 1 24 < 1

NEW ENGLAND 646 458 131 29 12 16 38 S. ATLANTIC 947 561 248 75 31 31Boston, Mass. 180 114 37 15 6 8 16 Atlanta, Ga. 107 69 23 11 3 1Bridgeport, Conn. 48 33 11 2 2 - 3 Baltimore, Md. 84 42 31 6 3Cambridge, Mass. 29 22 5 1 - 1 7 Charlotte, N.C. 43 19 14 5 2Fall River, Mass. 22 17 5 - - - - Jacksonville, Fla. 103 61 27 7 7 1Hartford, Conn. 62 35 19 4 2 2 - Miami, Fla. 108 70 21 11 2 4Lowell, Mass. 24 12 9 2 - 1 - Norfolk. Va. 54 29 19 3 1Lynn, Mass. 17 12 4 - - 1 — Richmond, Va. 61 34 18 7 -New Bedford, Mass. 23 16 7 — — - - Savannah, Ga. 32 14 11 2 2 3New Haven, Conn. 35 26 8 1 - - 2 St. Petersburg, Fla. 63 55 3 2 1Providence, R.l. § 43 41 - 1 - 1 2 Tampa, Fla. 70 41 21 2 4Somerville, Mass. 9 9 - - - - 1 Washington, D.C. 177 95 50 17 6 9Springfield, Mass. 53 40 9 2 1 1 I Wilmington, Del. 45 32 10 2 - 1Waterbury, Conn. 42 35 7 - - - 4Worcester, Mass. 59 46 10 1 1 1 2

E.S. CENTRAL 592 357 133 45 29 28Birmingham, Ala. 93 52 21 12 5 3

MID. ATLANTIC 2 ,6 1 6 1 ,7 2 4 6 10 168 68 46 101 Chattanooga, Tenn. 39 28 9 1 - IAlbany, N.Y. 52 35 12 - 4 1 — Knoxville, Tenn. 42 32 9 1 -Allentown, Pa. 25 20 5 - - - - Louisville, Ky. 87 54 23 2 5Buffalo, N.Y. 150 106 34 5 2 3 17 Memphis, Tenn. 154 90 29 10 10 15Camden, N.J. 28 14 8 4 2 - 1 Mobile, Ala. 58 37 12 5 2Elizabeth, N.J. 31 24 5 2 - - 2 Montgomery, Ala. 36 19 8 5 3 1Erie, Pa.t 43 29 9 1 1 3 — Nashville, Tenn. 83 45 22 9 4 3Jersey City. N.J. 55 32 22 1 - — -N.Y. City, N.Y. 1 ,4 0 9 946 309 98 36 20 49Newark, N.J. 67 31 21 8 4 3 4 W.S. CENTRAL 1 ,2 5 3 709 301 123 74 46Paterson, N.J. 29 20 5 1 — 3 1 Austin, Tex. 54 32 12 3 5 2Philadelphia, Pa.t 200 113 58 17 7 5 6 Baton Rouge, La. 53 40 3 3 2 5Pittsburgh, Pa. t 133 82 35 11 3 2 2 Corpus Christi, Tex. 37 21 9 3 1Reading, Pa. 40 34 5 1 - * 2 Dallas, Tex. 154 88 37 14 7Rochester, N.Y. 128 89 27 7 3 2 9 El Paso, Tex. 52 31 7 7 4Schenectady, N.Y. 19 10 8 1 - - - Fort Worth, Tex. 79 47 19 7 3 3Scranton, Pa.t 28 19 9 - - - 1 Houston, Tex. 424 198 117 66 39 4Syracuse, N.Y. 79 53 14 5 4 3 3 Little Rock, Ark. 45 25 14 2 - 4Trenton, N.J. 43 21 14 5 2 1 - New Orleans, La. 108 67 25 6 5Utica, N.Y. 22 17 5 — ’ - - 3 San Antonio, Tex. 145 93 33 7 6 6Yonkers, N.Y. 35 29 5 1 - - 1 Shreveport, La. 22 13 8 - - 1

Tulsa, Okla. 80 54 17 5 2

E.N. CENTRAL 2 ,2 7 1 L, 468 484 169 65 84 49Akron, Ohio 96 57 26 4 2 7 — MOUNTAIN 609 346 141 56 36 30Canton, Ohio 38 27 6 3 - 2 1 Albuquerque, N. Mex 94 37 27 15 14 1Chicago, III. 4 87 276 126 43 22 20 10 Colo. Springs, Colo. 47 28 12 4 3Cincinnati, Ohio 137 93 27 6 2 9 3 Denver, Colo. 126 70 23 13 6 14Cleveland, Ohio 176 102 51 10 6 7 - Las Vegas, Nev. 55 28 21 2 1 3Columbus, Ohio 133 80 32 9 3 9 3 Ogden, Utah 19 12 3 4 - -Dayton, Ohio 115 73 22 15 3 2 2 Phoenix, Ariz. 117 71 24 8 6 8Detroit, Mich. 282 173 55 34 8 12 6 Pueblo, Colo. 20 16 3 1 - -EvansviHe, Ind. 51 36 11 3 1 - 1 Salt Lake City, Utah 44 29 7 4 2 2Fort Wayne, Ind. 58 48 7 1 2 - 2 Tucson, Ariz. 87 55 21 5 4 2Gary, Ind. 20 11 6 2 - 1 -Grand Rapids, Mich. 58 40 12 4 1 1 2Indianapolis, Ind. 156 91 39 18 6 2 4 PACIFIC 1 ,6 2 4 1 ,0 7 7 310 113 59 64Madison, Wis. 36 26 1 5 1 3 6 Berkeley, Calif. 27 17 5 - 2 3Milwaukee, Wis. 116 87 22 3 2 2 1 Fresno, Calif. 70 49 8 7 2 4Peoria, III. 53 38 12 2 1 - — Glendale, Calif. 16 14 1 I - -Rockford. III. 57 37 13 2 3 2 2 Honolulu, Hawaii 51 28 16 2 1 4South Bend, Ind. 43 37 4 1 - 1 1 Long Beach, Calif. 86 52 24 8 1 1Toledo. Ohio§ 97 91 - 2 1 2 2 Los Angeles, Calif. 436 292 85 36 14 9Youngstown, Ohio 62 45 12 2 1 2 3 Oakland, Calif. 77 45 20 6 3 3

Pasadena, Calif. 26 23 - 2 1 -Portland, Oreg. 89 62 11 6 5 5

W.N. CENTRAL 683 437 159 35 28 24 19 Sacramento, Calif. 60 41 12 1 2 4Des Moines, Iowa 63 37 16 5 - 5 - San Diego, Calif. 165 102 38 10 3 12Duluth, Minn. 23 16 6 1 - - - San Francisco, Calif. 144 94 28 8 6 7Kansas City, Kans. 33 15 9 3 4 2 - San Jose, Calif. 161 118 27 7 6 3Kansas City, Mo. 117 76 27 4 6 4 6 Seattle, Wash. 133 84 25 13 6 5Lincoln, Nebr. 35 31 3 — 1 - 2 Spokane, Wash. 42 28 7 4 1 2Minneapolis, Minn. 69 44 13 5 3 4 2 Tacoma, Wash. 41 28 3 2 6 2Omaha, Nebr. 90 53 24 6 4 3 2St. Louis, Mo. 132 85 26 8 7 6 1 f tS t Paul, Minn. 69 45 20 1 3 - 2 TOTAL 1 1 ,2 4 1 7 ,1 3 7 2 .5 1 7 813 402 369Wichita, Kans. 52 35 15 2 ~ 4

'M orta lity data in this table are voluntarily reported from 121 cities in the United States, most of which have populations of 100,000 or more. A death is reported by the place of its occurrence and by the week that the death certificate was filed. Fetal deaths are not included.

* * Pneumonia and influenzatBecause of changes in reporting methods in these 4 Pennsylvania cities, these numbers are partial counts for the current week. Complete counts will

be available in 4 to 6 weeks. ttT o ta l includes unknown ages.

§Data not available this week. Figures are estimates based on average percent of.regional totals.

■ parTOTAl

326

1

533365

2314

0811

3312

2835I515

35493134236

5914131

113144627641

389

Vol. 30/No. 41 MMWR 521

Raynaud's Phenomenon — Continued3. Hamilton A. Effect o f the air hammer on the hands o f stonecutters. Bureau of Labor Statistics. Indus­

trial accidents & hygiene series no. 19, 1918.4. Taylor W. The vibration syndrome. London: Academic Press, 1974.5. Wasserman D, Taylor W , Curry M, eds. Proceedings o f the International Occupational Hand-Arm Vi­

bration Conference. Cincinnati: National Institute fo r Occupational Safety and Health, 1977. (DHEW publication no. [NIOSH] 77-170).

Surveillance Summary

Nutrition Surveillance — United States, 1980

The Coordinated Nutrition Surveillance Program o f the Centers fo r Disease Control uses nutrition-related data collected by local health departments as part of routine delivery of child health services. During 1980, data were submitted fo r more than 250,000 children, ages 6 m onths-10 years. These data concerned new patients at more than 1,300 clinics in 22 states.

The data consist primarily of identifying demographic information, height (length), weight, birth weight, and hemoglobin and/or hematocrit determinations. Data on height (length), weight, and age are converted to percentiles fo r height-for-age and weight-for-height, using the National Center fo r Health Statistics reference population ( / ) . Levels < 5 th percentile height-for-age and weight-for-height and > 9 5 th percentile weight-for-height are reported as potentially abnormal values. Results based on these cutoff points are shown in Table 2. (Asians 6 -10 years old are not represented because data for < 100 children were reported.)

TABLE 2. Nutrition indices, by age and ethnic group*

Height-for-age Weight-for-height

Age groupNumber

examinedPercentage in the 5th %tile

Percentage in the 5th %tile

Percentage in the 95th %tile

6-7 7 months White 20,072 9.1 4.2 7.8Black 10,622 12.4 4.8 10.1Hispanic 2,572 10.4 4.0 9.9American Indian 843 9.8 3.1 13.3Asian 244 14.8 4.5 6.612-23 months White 27,810 10.9 4.7 9.7Black 13,879 12.2 5.1 11.2Hispanic 3,494 12.4 4.8 12.0American Indian 934 15.5 5.5 14.0Asian 407 28.0 9.1 5.72-5 years White 61,911 9.0 2.4 7.4Black 30,057 6.3 3.6 6.9Hispanic 8,143 11.9 2.2 11.6American Indian 2,122 10.9 2.3 16.1Asian 927 28.3 2.4 6.66-10 years White 18,347 6.5 2.3 5.2Black 10,358 3.1 3.7 3.7Hispanic 1,144 8.9 1.9 7.7American Indian 200 2.5 1.0 5.5

*For children screened January-December 1980, CDC Coordinated N u tr ition Surveillance.

N u tritio n — ContinuedFor children 6 months-5 years old, data from the surveillance population show greater

percentages of children in each age/ethnic group whose height-for-age levels are < 5 th per­centile than do data from the reference population. These percentages are highest among Asian children who range from 14.8% for the 6-1 1 month age group to 28.3% for the 2-5 year group. Low height-for-age values (< 5th percentile) show a peak fo r 11-23 month olds. There is a slight decrease in the prevalence of these low values for the 2-5 year age group and a more marked decrease for the 6 -10 year age group. This pattern is particularly evident in the black population, where the prevalence of low height-for-age levels is 1 2.2% for the 11-23 month age group and 3.1% for 6 -10 year olds. These changes with increasing age may represent secular differences among age cohorts or may be a result of catch-up growth, but this cannot be determined from cross-sectional data alone. A comparison o f low height- for-age values fo r 11 -23 month old whites, blacks, and Hispanics in 1 978 with values for 3-4 year olds in 1980 suggests that there may indeed be catch-up growth and improvement in overall nutritional status.

W eight-for-height is the anthropometric index related to possibly acute undernutrition. The prevalence of low weight-for-height levels (< 5th percentile) is consistently at or below 5% for all age/ethnic groups (except Asians 11-23 months old). The data suggest that acute undernutrition is not a major public health problem in these ethnic populations and that the overall growth and development of these groups is similar to that of a representative group of U.S. children. However, overweight children (weight-for-height > 9 5 th percentile) constitute more than the 5% of the population that would be expected from a normal distribution of an­thropometric values. Overweight is generally more prevalent among Hispanics and American Indians than among other ethnic groups. There is a slight decrease with age in the tendency fo r children to be overweight except among American Indians, for whom there is an increase.

In 1 980, there was a large influx into the United States of Southeast Asian refugee child­ren, many of whom were treated at clinics submitting nutrition surveillance data. Data on more than 1,700 of these children, ages 6 months-10 years, are presented in Table 3. Com­parison of these figures with those in Table 2 shows that the refugee children have greater prevalences of low height-for-age and low weight-for-height levels than do any o f the other groups of children. This is consistent w ith data from developing countries throughout the world. Attempts have been made to separate data on Southeast Asians from those on other Asians, but the high percentage of low height-for-age and low weight-for-height values seen in the total Asian population may result partially from the inclusion of some refugee children.

There is no consensus on which levels of hemoglobin and/or hematocrit should be used to define low values and/or anemia. Most clinics providing data to the nutrition surveillance system have adjusted the levels to reflect normal increases in hemoglobin that occur with age. At present, these values are 10.0 g /100 ml fo r children 6-23 months old, 11.0 g /100 ml

522 MMWR October 23, 1981

TABLE 3. Nutrition indices for Southeast Asian refugees by age*

Age groupNumber

examined

Height-for-age Weight-for-height

Percentage in the 5 th %tile

Percentage in the 5 th %tile

Percentage in the 95th %tile

6-23 months 329 31.6 10.0 3.02-5 years 810 42.6 5.3 4.26-10 years 579 47.3 4.3 1.6

* F o r ch ild ren screened January-D ecem ber 1980, CDC C oord ina ted N u tr it io n Surve illance.

Vol. 30/No. 41 MMWR 523

N utrition — Continuedfor 2-5 year olds, and 1 2.0 g /100 ml fo r 6 -10 year olds. The World Health Organization and others have suggested the use of 11.0 g /100 ml fo r the age range 6 months-5 years. To pro­vide widely useful information, Table 4 lists, by age and ethnic group, 4 selected cutoff points for hemoglobin prevalences. These data show that the prevalence of low hemoglobin levels is 9reatest fo r the 6-23 month group, remains high for 2-5 year olds, and decreases markedly for the 6 -10 year group. In all age groups, blacks tend to have greater prevalences of low hemoglobin values than do other ethnic groups, w ith the exception of 6 -23 month old Asians. Here, too, the inclusion of Southeast Asian refugee children may have lowered the hemoglobin values in Asians =£2 years old. Data on the prevalence of hematocrit levels below the 4 selected cuto ff points are presented in Table 5. The same pattern of prevalences among age/ethnic groups is evident fo r both hematocrit and hemoglobin data.

Low hemoglobin and/or hematocrit levels, indicative o f probable anemia due to iron defi­ciency, remain a major problem in these population groups. Because the selection of any specific cuto ff level fo r hematocrit/hemoglobin values identifies a population consisting of both normal and abnormal individuals, the lower the level selected the higher the probability that individuals in that group will be abnormal. The use of a commonly accepted hemoglobin cutoff of 11.0 g/1 00 ml fo r the group 6-23 months old, suggests that between 25% and 33% of this population are potentially anemic.Reported by Field Services Br, Nutrition Div, Center fo r Health Promotion and Education, CDC.Reference1 ■ National Center for Health Statistics. NCHS growth curves for children, b irth -18 years, United States.

Rockville, Md.: National Center fo r Health Statistics, 1 977. (Vital and health statistics. Series II: Data from the National Health Survey, no. 165).

TABLE 4. Prevalence (%) of persons examined with hemoglobin values below selected cutoff points by age and ethnic group

^9e groupNumber

examined 10.0

Hemoglobin (g/100 ml)

11.0 11.5 12.0

7 7 months White 5,387 6.8 27.9 51.4 64.0Black 3,526 7.6 33.9 55.2 69.9Hispanic 1,049 6.2 23.5 40.1 57.7Asian 88 9.1 34.1 53.4 62.512-23 months White 8,117 6.8 25.9 46.2 58.3Black 5,465 8.4 31.8 51.2 66.3Hispanic 1,273 8.1 24.4 38Æ 52.9Asian 164 15.2 34.8 44.5 59.1•2-5 years White 15,805 2.7 15.6 29.7 43.6Black 9,919 4.7 22.4 40.4 56.6Hispanic 3,019 2.5 11.5 21.2 32.3Asian 325 2.2 14.2 23.7 36.36~10 years White 1,819 0.1 1.8 6.1 16.1Black 1,514 0.6 6.1 17.8 32.4Hispanic 401 0.5 1.2 3.5 8.5

"F o r ch ild ren screened January-Decem ber 1980, CDC C oord ina ted N u tr it io n Surveillance.

N u tritio n — Continued

TABLE 5. Prevalence (%) of persons examined with hematocrit values below selected cutoff points by age and ethnic group*

524 MMWR October 23, 1981

Age groupNumber

examined 31

Hematocrit (%)

33 35 37

6-11 months White 16,362 7.8 21.0 46.5 73.5Black 8,842 8.7 21.8 48.0 74.4Hispanic 1,722 8.5 24.0 51.0 77.4Asian 185 8.6 18.9 33.3 58.112-23 months White 21,677 6.2 16.4 39.0 67.3Black 11,090 8.5 20.1 44.0 70.5Hispanic 2,495 6.4 17.7 39.8 68.0Asian 315 6.3 18.1 33.3 58.12-5 years White 54,391 3.1 9.2 26.5 55.8Black 27,436 4.9 12.3 31.9 59.6Hispanic 5,849 3.3 10.2 29.7 57.0Asian 736 3.0 8.7 21.6 48.06-10 years White 18,090 0.3 1.3 6.5 23.5Black 10,403 0.7 2.5 10.0 30.9Hispanic 904 0.7 2.8 8.7 27.5 -

•For children screened January-December 1980, CDC Coordinated Nutrition Surveillance.

The Morbidity and Mortality Weekly Report, circulation 96,000, is published by the Centers f ° r Disease Control, Atlanta, Georgia. The data in this report are provisional, based on weekly telegraphs to CDC by state health departments. The reporting week concludes at close of business on Friday; compiled data on a national basis are officially released to the public on the succeeding Friday.

The editor welcomes accounts of interesting cases, outbreaks, environmental hazards, or other public health problems of current interest to health officials. Send reports to: Attn: Editor, Morbidity and Mortality Weekly Report, Centers for Disease Control, Atlanta, Georgia 30333.

Send mailing list additions, deletions and address changes to: Attn: Distribution Services, Manage­ment Analysis and Services Office, 1-SB-419, Centers for Disease Control, Atlanta, Georgia 30333. When requesting changes be sure to give your former address, including zip code and mailing list code number, or send an old address label.

U.S. DEPARTMENT OF HEALTH AND HUM AN SERVICESPUBLIC HEALTH SERVICE / C ENTERS FOR D ISEASE C O N TR O L A T L A N T A , G E O R G IA 30333 O FFIC IA L BUSINESS

Postage and Fees Paid U.S. Department of HHS

Director, Centers for Disease Control HHS 396William H. Foege, M .D .

Director, Epidemiology Program Office Philip S. Brachman, M .D.

EditorMichael B. Gregg, M .D.

Mathematical Statistician Keewhan Choi, Ph.D.

A J 012 PUBA63 8130 012 OFFICE OF PUBLIC AFFAIRSC DuBLDG 1-2067

111

HHS Publication No. (CDC) 81-8017 Redistribution using indicia is illegal-